Waldenström's macroglobulinemia medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
There are several different options for treating waldenström macroglobulinemia depending on the disease | There are several different options for treating waldenström macroglobulinemia depending on stage of the disease.<ref name=Tx>Lymphoplasmacytic lymphoma. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/lymphoplasmacytic-lymphoma/?region=ab Accessed on November 6 2015 </ref> | ||
====Asymptomatic/Smoldering Waldenström's Macroglobulinemia==== | ====Asymptomatic/Smoldering Waldenström's Macroglobulinemia==== | ||
There is no treatment for asymptomatic waldenström's macroglobulinemia.<ref name="BM">Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015</ref> | |||
Asymptomatic waldenström's macroglobulinemia can be monitored every 3-6 months - a 'wait and watch approach'. | |||
====Symptomatic Waldenström's Macroglobulinemia==== | ====Symptomatic Waldenström's Macroglobulinemia==== | ||
Symptomatic patients with waldenström macroglobulinemia are started on chemotherapy depending on the stage.<ref name="ADR">Waldenström's macroglobulinemia: prognosis and management. Blood Cancer Journal (2015)http://www.nature.com/bcj/journal/v5/n3/full/bcj201528a.html Accessed on November 13, 2015</ref> | Symptomatic patients with waldenström macroglobulinemia are started on chemotherapy depending on the stage.<ref name="ADR">Waldenström's macroglobulinemia: prognosis and management. Blood Cancer Journal (2015)http://www.nature.com/bcj/journal/v5/n3/full/bcj201528a.html Accessed on November 13, 2015</ref> | ||
*Initial stage of waldenström's macroglobulinemia associated with | *Initial stage of waldenström's macroglobulinemia associated with: | ||
:*Neuropathy, | :*[[Neuropathy]], | ||
:*Anemia or cytopenias, | :*[[Anemia]] or [[cytopenias]], | ||
:*Low-volume nodal involvement, and | :*Low-volume nodal involvement, and | ||
:*Asymptomatic splenomegaly | :*Asymptomatic [[splenomegaly]] | ||
'''Treatment:''' Single-agent Rituximab therapy | '''Treatment:''' Single-agent [[Rituximab]] therapy | ||
*Late stage of waldenström's macroglobulinemia associated with | *Late stage of waldenström's macroglobulinemia associated with: | ||
:*Adenopathy, | :*Adenopathy, | ||
:*Symptomatic splenomegaly, | :*Symptomatic splenomegaly, | ||
Revision as of 05:55, 8 January 2016
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Waldenström's macroglobulinemia Microchapters |
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Differentiating Waldenström's macroglobulinemia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Waldenström's macroglobulinemia medical therapy On the Web |
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American Roentgen Ray Society Images of Waldenström's macroglobulinemia medical therapy |
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Directions to Hospitals Treating Waldenström's macroglobulinemia |
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Risk calculators and risk factors for Waldenström's macroglobulinemia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]
Overview
Risk stratification determines the protocol of management used for waldenström's macroglobulinemia. The mainstay of therapy for asymptomatic waldenström's macroglobulinemia is watchful waiting. Symptomatic waldenström's macroglobulinemia is treated with Rituximab +/- Chemotherapy.[1]
Medical Therapy
There are several different options for treating waldenström macroglobulinemia depending on stage of the disease.[2]
Asymptomatic/Smoldering Waldenström's Macroglobulinemia
There is no treatment for asymptomatic waldenström's macroglobulinemia.[3] Asymptomatic waldenström's macroglobulinemia can be monitored every 3-6 months - a 'wait and watch approach'.
Symptomatic Waldenström's Macroglobulinemia
Symptomatic patients with waldenström macroglobulinemia are started on chemotherapy depending on the stage.[1]
- Initial stage of waldenström's macroglobulinemia associated with:
- Neuropathy,
- Anemia or cytopenias,
- Low-volume nodal involvement, and
- Asymptomatic splenomegaly
Treatment: Single-agent Rituximab therapy
- Late stage of waldenström's macroglobulinemia associated with:
- Adenopathy,
- Symptomatic splenomegaly,
- Cytopenias,
- Hyperviscosity syndrome,
- Neuropathy, or
- Constitutional symptoms
Treatment:[1]
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CHOP-R regimen |
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Ibrutinib |
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Rituximab |
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FR regimen |
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BDR regimen |
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DRC regimen |
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CR regimen |
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Hyperviscosity syndrome
- Plasmapheresis is recommended emergent treatment option for patients with waldenström macroglobulinemia who develop hyperviscosity symptoms.[1]
- Plasmapheresis temporarily lowers IgM levels by removing some of the abnormal IgM from the blood, which makes the blood thinner.
- However, plasmapheresis does not affect the lymphoma cells.
- Plasmapheresis is usually given until chemotherapy starts to work.
- Plasmapheresis is combined with chemotherapy to control the disease for a longer period of time.
References
- ↑ 1.0 1.1 1.2 1.3 Waldenström's macroglobulinemia: prognosis and management. Blood Cancer Journal (2015)http://www.nature.com/bcj/journal/v5/n3/full/bcj201528a.html Accessed on November 13, 2015
- ↑ Lymphoplasmacytic lymphoma. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/lymphoplasmacytic-lymphoma/?region=ab Accessed on November 6 2015
- ↑ Waldenström's macroglobulinemia. Patient (2015)http://patient.info/doctor/waldenstroms-macroglobulinaemia-pro Accessed on November 10, 2015